tbuckley/cabot-search huggingface dataset:
Variation in Renal Function Following Transition to Sacubitril/Valsartan in Patients With Heart Failure
Authors: Safia Chatur, Brian L. Claggett, Finnian R. McCausland, Jean Rouleau, Michael R. Zile, Milton Packer, Marc A. Pfeffer, Martin Lefkowitz, John J.V. McMurray, Scott D. Solomon, Muthiah Vaduganathan
Journal: Journal of the American College of Cardiology (2023)

Some patients with heart failure may experience transient changes in kidney function upon transition to sacubitril/valsartan. Whether such changes portend adverse outcomes or influence long-term treatment benefits with sacubitril/valsartan continuation is unknown.This investigation aimed to evaluate the association between the occurrence of moderate estimated glomerular filtration rate (eGFR) decline (>15%) after initial exposure to sacubitril/valsartan and subsequent cardiovascular outcomes and its treatment benefits in PARADIGM-HF and PARAGON-HF.In sequential run-in phases, patients were titrated to enalapril 10 mg twice daily and then sacubitril/valsartan 97 mg/103 mg twice daily (in PARADIGM-HF) or valsartan 80 mg twice daily and then sacubitril/valsartan 49 mg/51 mg twice daily (in PARAGON-HF).Among randomized participants, 11% in PARADIGM-HF and 10% in PARAGON-HF experienced eGFR decline (>15%) during sacubitril/valsartan run-in. eGFR partially recovered (from nadir to postrandomization week 16) regardless of sacubitril/valsartan continuation or switch to renin-angiotensin system inhibitor (RASi) postrandomization. Initial eGFR decline was not consistently associated with clinical outcomes in either trial. Treatment benefits of sacubitril/valsartan vs RASi on primary outcomes were similar irrespective of run-in eGFR decline in PARADIGM-HF (eGFR decline, HR: 0.69; 95% CI: 0.53-0.90; and no eGFR decline, HR: 0.80; 95% CI: 0.73-0.88; Pinteraction = 0.32) and PARAGON-HF (eGFR decline, rate ratio [RR]: 0.84; 95% CI: 0.52-1.36 and no eGFR decline, RR: 0.87; 95% CI: 0.75-1.02, Pinteraction = 0.92). The treatment effect of sacubitril/valsartan remained consistent across a range of eGFR declines.Moderate eGFR decline when transitioning from RASi to sacubitril/valsartan is not consistently associated with adverse outcomes, and its long-term benefits are retained in heart failure across a broad range of eGFR declines. Early eGFR changes should not deter continuation of sacubitril/valsartan or stall uptitration. (Efficacy and Safety of LCZ696 Compared to Valsartan, on Morbidity and Mortality in Heart Failure Patients With Preserved Ejection Fraction [PARAGON-HF]; NCT01920711; Prospective Comparison of Angiotensin Receptor-Neprilysin Inhibitors with Angiotensin-Converting Enzyme Inhibitors to Determine Impact on Global Mortality and Morbidity in Heart Failure [PARADIGM-HF]; NCT01035255).
Intermuscular Fat Changes Are Related to Reduced Left Ventricular Ejection Fraction During Cancer Therapy (PREVENT-WF-98213)
Authors: Moriah P. Bellissimo, Kerryn W. Reding, Nathaniel S. O’Connell, Ralph B. D’Agostino, Leila Mabudian, Emily M. Heiston, Amy C. Ladd, Kathryn E. Weaver, Glenn J. Lesser, Bernard F. Fuemmeler, Fadi N. Salloum, W. Gregory Hundley
Journal: JACC CardioOncology (2023)
Recency of Heart Failure Hospitalization, Outcomes, and the Effect of Empagliflozin
Authors: João Pedro Ferreira, Faiez Zannad, Javed Butler, Gerasimos Filippatos, Stuart Pocock, Tomoko Iwata, Mikhail Sumin, Cordula Zeller, James L. Januzzi, Stefan D. Anker, Milton Packer
Journal: JACC Heart Failure (2023)

Patients with a recent heart failure (HF) hospitalization have a high risk of rehospitalization and mortality. Early treatment may have a substantial impact on patient outcomes.This study sought to study the outcomes and effect of empagliflozin according to timing of prior HF hospitalization.EMPEROR-Pooled (EMPEROR-Reduced [EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Reduced Ejection Fraction] and EMPEROR-Preserved [EMPagliflozin outcomE tRial in Patients With chrOnic heaRt Failure With Preserved Ejection Fraction] combined) included 9,718 HF patients who were grouped according to the recency of HF hospitalization (none, <3 months, 3-6 months, 6-12 months, >12 months). The primary outcome was a composite of time to first of HF hospitalization or cardiovascular death, over a median follow-up of 21 months.The primary outcome event rates (per 100 person-years) in the placebo group were 26.7, 18.1, 13.7, and 2.8 for patients hospitalized within 3 months, 3-6 months, 6-12 months, and >12 months, respectively. The relative risk reduction of primary outcome events with empagliflozin was similar across HF hospitalization categories (P interaction = 0.67). The primary outcome absolute risk reduction was more pronounced among patients with a recent HF hospitalization but without statistical heterogeneity of treatment effect: -6.9, -5.5, -0.8, and -0.6 events prevented per 100 person-years for patients hospitalized within <3 months, 3-6 months, 6-12 months, and >12 months, respectively, and -2.4 events prevented per 100 person-years of follow-up in those without a prior HF hospitalization (P interaction = 0.64). Empagliflozin was safe irrespective of HF hospitalization recency.Patients with a recent HF hospitalization have a high risk of events. Empagliflozin reduced HF events regardless of HF hospitalization recency.
Out-of-Pocket Drug Costs for Medicare Beneficiaries With Cardiovascular Risk Factors Under the Inflation Reduction Act
Authors: Prihatha R. Narasimmaraj, Andrew Oseran, Archana Tale, Jiaman Xu, Utibe R. Essien, Dhruv S. Kazi, Robert W. Yeh, Rishi K. Wadhera
Journal: Journal of the American College of Cardiology (2023)
Engineering of a NIR-activable hydrogel-coated mesoporous bioactive glass scaffold with dual-mode parathyroid hormone derivative release property for angiogenesis and bone regeneration
Authors: Shi Liu, Zhengzhe Han, Ji-Na Hao, Dapeng Zhang, Xianglong Li, Yuanyuan Cao, Jinghuan Huang, Yongsheng Li
Journal: Bioactive Materials (2023)

Osteogenesis, osteoclastogenesis, and angiogenesis play crucial roles in bone regeneration. Parathyroid hormone (PTH), an FDA-approved drug with pro-osteogenic, pro-osteoclastogenic and proangiogenic capabilities, has been employed for clinical osteoporosis treatment through systemic intermittent administration. However, the successful application of PTH for local bone defect repair generally requires the incorporation and delivery by appropriate carriers. Though several scaffolds have been developed to deliver PTH, they suffer from the weaknesses such as uncontrollable PTH release, insufficient porous structure and low mechanical strength. Herein, a novel kind of NIR-activable scaffold (CBP/MBGS/PTHrP-2) with dual-mode PTHrP-2 (a PTH derivative) release capability is developed to synergistically promote osteogenesis and angiogenesis for high-efficacy bone regeneration, which is fabricated by integrating the PTHrP-2-loaded hierarchically mesoporous bioactive glass (MBG) into the N-hydroxymethylacrylamide-modified, photothermal agent-doped, poly(N-isopropylacrylamide)-based thermosensitive hydrogels through assembly process. Upon on/off NIR irradiation, the thermoresponsive hydrogel gating undergoes a reversible phase transition to allow the precise control of on-demand pulsatile and long-term slow release of PTHrP-2 from MBG mesopores. Such NIR-activated dual-mode delivery of PTHrP-2 by this scaffold enables a well-maintained PTHrP-2 concentration at the bone defect sites to continually stimulate vascularization and promote osteoblasts to facilitate and accelerate bone remodeling. In vivo experiments confirm the significant improvement of bone reparative effect on critical-size femoral defects of rats. This work paves an avenue for the development of novel dual-mode delivery systems for effective bone regeneration.
Table of Contents
Authors: A Rosenberg, E Vokes, Z Kuzbari, C Bandlamudi, C Loveday, A Garrett, M Mehine, A George, H Hanson, K Snape, A Kulkarni, S Allen, S Jezdic, R Ferrandino, C Westphalen, E Castro, J Rodon, J Mateo, G Burghel, M Berger, D Mandelker, C Turnbull, A Krämer, T Bochtler, C Pauli, G Baciarello, S Delorme, K Hemminki, L Mileshkin, H Moch, K Oien, T Olivier, A Chan, V Lee, R.-L Hong, M.-J Ahn, W Chong, S.-B Kim, G Ho, P Caguioa, N Ngamphaiboon, C Ho, M Aziz, Q Ng, C.-J Yen, N Soparattanapaisarn, -C Ngan, S Kho, M Tiambeng, T Yun, V Sriuranpong, A Algazi, A Cheng, E Massarelli, R Swaby, S Saraf, J Yuan, L Siu, A Psyrri, J Fayette, K Harrington, M Gillison, S Takahashi, J Weiss, J.-P Machiels, S Baxi, A Vasilyev, A Karpenko, M Dvorkin, C.-Y Hsieh, S Thungappa, P Segura, I Vynnychenko, R Haddad, S Kasper, P.-S Mauz, V Baker, P He, B Evans, S Wildsmith, R Olsson, A Yovine, J Kurland, N Morsli, T Seiwert, S Scalera, B Ricciuti, M Mazzotta, N Calonaci, J Alessi, L Cipriani, G Bon, B Messina, G Lamberti, A Federico, F Pecci, S Milite, E Krasniqi, M Barba, P Vici, A Vecchione, F De Nicola, L Ciuffreda, F Goeman, M Fanciulli, S Buglioni, E Pescarmona, B Sharma, K Felt, J Lindsay, S Rodig, R De Maria, G Caravagna, F Cappuzzo, G Ciliberto, M Awad, M Maugeri-Saccà, A Balar, D Castellano, P Grivas, D Vaughn, T Powles, J Vuky, Y Fradet, J.-L Lee, L Fong, N Vogelzang, M Climent, A Necchi, D Petrylak, E Plimack, J Xu, K Imai, B Moreno, J Bellmunt, R De Wit, P O'donnell, K White, K Connor, M Meylan, A Bougoüin, M Salvucci, F Bielle, A O'farrell, K Sweeney, L Weng, G Bergers, P Dicker, D Ashley, E Lipp, J Low, J Zhao, P Wen, R Prins, M Verreault, A Idbaih, A Biswas, J Prehn
Journal: Annals of Oncology (2023)
Artificial intelligence and high-dimensional technologies in the theragnosis of systemic lupus erythematosus
Authors: Katherine Nay Yaung, Joo Guan Yeo, Pavanish Kumar, Martin Wasser, Marvin Chew, Angelo Ravelli, Annie Hui Nee Law, Thaschawee Arkachaisri, Alberto Martini, David S Pisetsky, Salvatore Albani
Journal: The Lancet Rheumatology (2023)
Detailing the influence of PEO-coated biodegradable Mg-based implants on the lacuno-canalicular network in sheep bone: A pilot study
Authors: Jonathan Espiritu, Sandra Sefa, Hanna Ćwieka, Imke Greving, Silja Flenner, Regine Willumeit-Römer, Jan-Marten Seitz, Berit Zeller-Plumhoff
Journal: Bioactive Materials (2023)

An increasing prevalence of bone-related injuries and aging geriatric populations continue to drive the orthopaedic implant market. A hierarchical analysis of bone remodelling after material implantation is necessary to better understand the relationship between implant and bone. Osteocytes, which are housed and communicate through the lacuno-canalicular network (LCN), are integral to bone health and remodelling processes. Therefore, it is essential to examine the framework of the LCN in response to implant materials or surface treatments. Biodegradable materials offer an alternative solution to permanent implants, which may require revision or removal surgeries. Magnesium alloys have resurfaced as promising materials due to their bone-like properties and safe degradation in vivo. To further tailor their degradation capabilities, surface treatments such as plasma electrolytic oxidation (PEO) have demonstrated to slow degradation. For the first time, the influence of a biodegradable material on the LCN is investigated by means of non-destructive 3D imaging. In this pilot study, we hypothesize noticeable variations in the LCN caused by altered chemical stimuli introduced by the PEO-coating. Utilising synchrotron-based transmission X-ray microscopy, we have characterised morphological LCN differences around uncoated and PEO-coated WE43 screws implanted into sheep bone. Bone specimens were explanted after 4, 8, and 12 weeks and regions near the implant surface were prepared for imaging. Findings from this investigation indicate that the slower degradation of PEO-coated WE43 induces healthier lacunar shapes within the LCN. However, the stimuli perceived by the uncoated material with higher degradation rates induces a greater connected LCN better prepared for bone disturbance.
Glucocorticoid Toxicity Index scores by domain in patients with antineutrophil cytoplasmic antibody-associated vasculitis treated with avacopan versus standard prednisone taper: post-hoc analysis of data from the ADVOCATE trial
Authors: Naomi J Patel, David R W Jayne, Peter A Merkel, Pirow Bekker, Yuqing Zhang, Huibin Yue, John H Stone
Journal: The Lancet Rheumatology (2023)
Investigational Treatments
Authors: David M. Eddy
Journal: JAMA (1997)

THE BENEFIT LANGUAGE described in the previous article<sup>1</sup>described what might be called "evidence- and outcomes-based criteria"<sup>2</sup>for coverage: Treatments should be backed by sufficient evidence to determine their effects on health outcomes, and a comparison of the outcomes should show that the treatment is effective, beneficial, and cost-effective. This article will focus on the first of these criteria—that treatments should be backed by solid evidence of effectiveness. In one sense, this criterion should be the least controversial, because it corresponds to the "investigational" exclusion that has appeared for decades in the contracts of almost all traditional fee-for-service insurers, health maintenance organizations, and government programs. (Henceforth I will use the word "plan" to include all types of organizations that finance and/or deliver health care, and the word "treatment" to include all types of health interventions.) Recently, however, this criterion has become far more controversial because of reports
Hand washing
Authors: A. Weeks, R. Sen, M. Keaney, A. Trail, C. Howard, P. Chadwick, S Kesavan, C R. B Welbourn, S. M Jones, P. M Hateley, P A Jurnaa, R. MacDermott, D Varghese, H Patel, A M. Katme
Journal: BMJ (1999)

# Why I don't wash my hands between each patient contact {#article-title-2} EDITOR—The editorial on hand washing calls for all hospital staff to start regularly washing their hands between each patient contact.1 If, as the authors claim, there is such compelling evidence for the need to wash hands between each patient contact then why do I and the vast majority of my colleagues not do it? Firstly, I have never seen any convincing evidence that hand washing between each patient contact reduces infection rates. The Handwashing Liaison Group assumes that we all know that hand washing is beneficial and therefore fails to put forward any evidence for it. It seems self evident that hand washing should be beneficial before and after a person has performed any procedures, examined wounds, or dealt with specifically high risk patients, but I have never seen any evidence for it in other situations. I shake hands with patients when I see them in hospital. Should I not do this, or should I wash my hands before and after each contact? Should patients be discouraged from social contacts with each other? Where is the evidence? Secondly, I have maybe 60 “touch” contacts with patients each day, and many more with relatives. Washing hands between each contact (at 1-2 minutes per wash) would take on average 1-2 hours. Where will this time come from, and who will fund it? If hand washing is to be performed between every patient contact then it would have major resource implications. For this it needs to be shown to be effective and worth the 15% extra staffing that would be needed to cover the extra time. 1. 1.↵1. Handwashing Liaison Group . Hand washing. BMJ 1999; 318: 686. (13 March.) [OpenUrl][1][FREE Full Text][2] # Healthcare workers washed their hands on only a third of occasions {#article-title-4} EDITOR—We agree with the Handwashing Liaison Group that an explicit standard for hand washing needs to be set and that hand washing should be regarded as part of the normal duty of care.1 The group … [1]: {openurl}?query=rft.jtitle%253DBMJ%26rft.stitle%253DBMJ%26rft.issn%253D0007-1447%26rft.aulast%253DHandwashing%2BLiaison%2BGroup%26rft.auinit1%253D%2B%26rft.volume%253D318%26rft.issue%253D7185%26rft.spage%253D686%26rft.epage%253D686%26rft.atitle%253DHand%2Bwashing%26rft_id%253Dinfo%253Apmid%252F10073995%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/ijlink?linkType=FULL&journalCode=bmj&resid=318/7185/686&atom=%2Fbmj%2F319%2F7208%2F518.atom
Clinical Prediction Rules&lt;subtitle&gt;A Review and Suggested Modifications of Methodological Standards&lt;/subtitle&gt;
Authors: Andreas Laupacis
Journal: JAMA (1997)

<h3>Background.</h3> —Clinical prediction rules are decision-making tools for clinicians, containing variables from the history, physical examination, or simple diagnostic tests. <h3>Objective.</h3> —To review the quality of recently published clinical prediction rules and to suggest methodological standards for their development and evaluation. <h3>Data Sources.</h3> —Four general medical journals were manually searched for clinical prediction rules published from 1991 through 1994. <h3>Study Selection.</h3> —Four hundred sixty potentially eligible reports were identified, of which 30 were clinical prediction rules eligible for study. Most methodological standards could only be evaluated in 29 studies. <h3>Data Abstraction.</h3> —Two investigators independently evaluated the quality of each report using a standard data sheet. Disagreements were resolved by consensus. <h3>Data Synthesis.</h3> —The mathematical technique was used to develop the rule, and the results of the rule were described in 100% (29/29) of the reports. All the rules but 1 (97% [28/29]) were felt to be clinically sensible. The outcomes and predictive variables were clearly defined in 83% (24/29) and 59% (17/29) of the reports, respectively. Blind assessment of outcomes and predictive variables occurred in 41% (12/29) and 79% (23/29) of the reports, respectively, and the rules were prospectively validated in 79% (11/14). Reproducibility of predictive variables was assessed in only 3% (1/29) of the reports, and the effect of the rule on clinical use was prospectively measured in only 3% (1/30). Forty-one percent (12/29) of the rules were felt to be easy to use. <h3>Conclusions.</h3> —Although clinical prediction rules comply with some methodological criteria, for other criteria, better compliance is needed.
Cost of and Payment Source for Pelvic Inflammatory Disease
Authors: A. Eugene Washington
Journal: JAMA (1991)

Pelvic inflammatory disease (PID) and its sequelae affect millions of women in the United States at substantial costs. To estimate these total costs annually and to determine payment sources, we analyzed data from local, state, and national sources. Direct costs for PID and PID-associated ectopic pregnancy and infertility were estimated to be $2.7 billion, and indirect costs were estimated to be $1.5 billion, for a total cost of $4.2 billion in 1990. Overall, private insurance covered the largest portion of the direct costs of PID (41%), followed by public payment sources (30%). However, the proportion of payments made by private insurance appears to be decreasing, while that by public payment sources is increasing. In the year 2000, costs associated with PID are projected to approach $10 billion if the current PID incidence persists, with an increasing proportion of this expense burdening public institutions. Prevention of PID is needed both to reduce human suffering and to contain rising costs. (<i>JAMA</i>. 1991;266:2565-2569)
Preoperative Use of Enoxaparin Compared With Unfractionated Heparin Increases the Incidence of Re-Exploration for Postoperative Bleeding After Open-Heart Surgery in Patients Who Present With an Acute Coronary Syndrome
Authors: Heath U. Jones, Joseph B. Muhlestein, Kent W. Jones, Tami L. Bair, Farangis Lavasani, Mahtab Sohrevardi, Benjamin D. Horne, Donald Doty, Donald L. Lappe
Journal: Circulation (2002)

Background Enoxaparin has become an attractive therapy for use during acute coronary syndrome (ACS) because of its potential superior efficacy over unfractionated heparin (UFH), its longer activity, and its subcutaneous route of administration. However, because a significant number of patients presenting with ACS may be sent directly to open heart surgery while still on anticoagulation, it is important to understand any potential bleeding risks that may be associated with the use of enoxaparin under these circumstances. Methods From 1998 to 2001, 1159 consecutive patients presenting with an acute coronary syndrome who received either UFH (n=1008) or enoxaparin (n=151) before proceeding to open heart surgery for urgent therapy during the same hospitalization were included in this study. Incidence of perioperative bleeding as evidenced by the units of blood products (packed red blood cells or platelets) transfused or the need for surgical re-exploration for postoperative bleeding was recorded. Results Average age was 65±11 and 67±11 years for patients receiving UFH and enoxaparin, respectively ( P= 0.005). Seventy-five percent of those receiving UFH and 64% of those receiving enoxaparin ( P &lt;0.005) were males. After discharge, the incidence of rehospitalization for hemorrhage requiring return to surgery for re-exploration was 7.9% in the enoxaparin group and 3.7% in the UFH group (adjusted hazard ratio=2.6, P =0.03). The use of blood products did not differ between groups (UFH=2.7±6.5 U and enoxaparin=2.3±4.5 U; P =NS). Conclusion The preoperative use of enoxaparin compared with UFH in patients presenting with an ACS who undergo open-heart surgery during the same hospitalization is associated with a significantly increased incidence of re-exploration for postoperative bleeding. Further study is needed to understand the mechanism of this phenomenon and to develop appropriate guidelines to address this potentially important issue.
Uric Acid Metabolism and Tubular Sodium Handling
Authors: Francesco P. Cappuccio
Journal: JAMA (1993)

<h3>Objective.</h3> —To define the relationship, if any, between uric acid metabolism (serum and urinary levels) and proximal tubular sodium handling in a sample of general male population. <h3>Design.</h3> —Cross-sectional survey of a sample of the male working population conducted as part of a nationwide survey of the prevalence of cardiovascular risk factors. <h3>Setting.</h3> —The Olivetti factory in Pozzuoli, a suburb of Naples, Italy. <h3>Participants.</h3> —Five hundred sixty-eight untreated male workers aged 21 to 68 years (90.8% of those eligible). <h3>Measurements.</h3> —Anthropometry, blood pressure, blood tests, a detailed questionnaire, and urinary measurements on a fasting timed collection after a 300-mg lithium carbonate capsule was taken the night before the investigation. <h3>Results.</h3> —Serum uric acid level was inversely and significantly associated with the fractional excretion of lithium (<i>r</i>=-.22,<i>P</i>&lt;.001), ie, the higher the serum uric acid level, the greater the amount of sodium reabsorbed at nephron sites proximal to the distal tubule. The association was graded and independent of possible confounders such as age, body mass, smoking, wine consumption, blood pressure, fractional excretion of sodium, and serum creatinine (<i>R</i><sup>2</sup>=.34,<i>P</i>&lt;.001). <h3>Conclusions.</h3> —High serum uric acid levels are independently associated with increased proximal tubular sodium reabsorption in men. This relationship suggests an altered tubular sodium handling and uric acid metabolism consistent with hyperinsulinemia, insulin resistance being the possible pathophysiological link. (<i>JAMA</i>. 1993;270:354-359)